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Heart failure with reduced ejection fraction — ABFM Board MCQ

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ModerateCardiovascularHeart failure with reduced ejection fractionABFM Board

A 64-year-old man with ischemic cardiomyopathy has increasing ankle swelling and dyspnea on exertion. His echocardiogram last year showed an ejection fraction of 32%. He takes lisinopril and metoprolol succinate. Which of the following is the most appropriate initial treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Add a loop diuretic for symptomatic congestion

Loop diuretics provide symptomatic relief of fluid overload in heart failure with reduced ejection fraction, while disease-modifying therapies are continued when tolerated.

Reference: 2022 AHA/ACC/HFSA Heart Failure Guideline: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001063